Provider Demographics
NPI:1881897080
Name:ACACIA ENDODONTICS, PLLC
Entity type:Organization
Organization Name:ACACIA ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-777-9938
Mailing Address - Street 1:1300 N MCCLINTOCK DR
Mailing Address - Street 2:STE B2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-7205
Mailing Address - Country:US
Mailing Address - Phone:480-777-9938
Mailing Address - Fax:480-491-0132
Practice Address - Street 1:1300 N MCCLINTOCK DR
Practice Address - Street 2:STE B2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-7205
Practice Address - Country:US
Practice Address - Phone:480-777-9938
Practice Address - Fax:480-491-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty